Provider Demographics
NPI:1770064883
Name:MEKULA, MELISSA MARIE (LCPC, LADC)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:MARIE
Last Name:MEKULA
Suffix:
Gender:F
Credentials:LCPC, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 MORTLAND RD
Mailing Address - Street 2:
Mailing Address - City:SEARSPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04974-3336
Mailing Address - Country:US
Mailing Address - Phone:207-548-2475
Mailing Address - Fax:207-548-2470
Practice Address - Street 1:37 MORTLAND RD
Practice Address - Street 2:
Practice Address - City:SEARSPORT
Practice Address - State:ME
Practice Address - Zip Code:04974-3336
Practice Address - Country:US
Practice Address - Phone:207-548-2475
Practice Address - Fax:207-548-2470
Is Sole Proprietor?:No
Enumeration Date:2018-08-27
Last Update Date:2025-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC8324101YA0400X
MECC7442101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)